CLINICAL CASES

This case should be considered alongside case 2. Where Nux vom. had a similar “loosening” effect. If this is maintained, life can be much easier for the patient and, though one can scarcely expect reorganization of destroyed cartilage, this has occurred (Dr. Boyd quoted such a case years ago). The destruction in the case resembles that present in Charcot joints and in the joints of syringomyelia, in both of which the cause is neurogenetic and not toxic.

9. Miss B., aet. 55. Symptoms of indigestion for many months, getting gradually worse. Nausea soon after eating. Discomfort about on hour after meals. Better for eating. Despite several remedies this persisted and, though never acute, seemed to be too persistent to be neglected. It was arranged that if there was not a very marked improvement after the next treatment an X-ray examination was called for.

On this occasion she was rather incoherent about all her symptoms. Found herself unable to converse and repeated the last few words of what other people said to her. Melancholic feeling worse in morning. “If she tried to think of anything she went all hot on the left side of the face only.” “Effort to do anything.” Beginning to feel desperate.” Pressure on top of head. No initiative.

Tight feeling nose. All sorts of queer sensations. FEELS LIKE BLASTING AND DAMNING. Itching vulva nearly drives her desperate. Anacardium 200 one does was given and it all went. When seen 3 months later she had been very well and came back because of slight return of indigestion symptoms. Anacardium 1m was then given.

Anacardium has a so-called “nervous” type of indigestion relived by food. This is the type of indigestion which precedes actual formation and it is in this stage that one may hope to cure. Later when an ulcer has formed, more than mere drug therapy will be required before the ulcer will heal. Homoeopathic drug therapy is directed against those conditions which tend to ulceration. It is being widely recognized that nervous stated such as are described in the Anacardium symptomatology are common in the ulcer “make-up.”

In more profound mental states there is an hallucination “as if he is possessed of two persons of will” (Dr. Jekyll and Mr. Hyde) and should be considered in case of schizophrenia where the other symptoms correspond.

This is another case where the symptoms are so typical that recourse to repertorization hardly seems necessary. At any here the picture led to a consideration of the drug Anacardium in the Materia Medica and to the conclusion that the drug did cover accurately most of the patients symptoms.

In out-patient work and :desk” prescribing this method is adequate, and meets the criticism that homoeopathic prescribing takes too long to be of value in general practice. The only virtue in repertorization is that provides a method of finding the “simillimum” when there is not obvious drug picture.

There are some prescribers who have a flair for recognizing the drug in a case. The greater the knowledge of Materia Medica the more likely is this “gift” to be accurate. But even the beginner can find the simillimum if he uses the repertory as a guide to the Materia Medica.

The drug must not be chosen on a mathematical or numerical basis. Repertorization lists a number of drugs which have all or most of the symptoms of the patient, but only a study of these drugs with Materia Medica will decide which of them is the simillimum.

10, W. S., aet. 59.

Pain in the back for years, left side of the spine. Worse since a fall. Site of the pain varied, but it is more lumbar than sacral.

Sulphur is a great backache remedy. Most typical of its symptoms are perhaps (a) the stooped position in walking. and (b) the extension of the pain when the sit is sacro-lumbar round to the groins, but it always pays to run the outstanding modalities through the repertory, as not infrequently another less common remedy like Aesculus or Agaricus comes through. In this case Sulph. was finally chosen on the unusual symptom of compelled to walk bent. Aesculus is more typically sacrolumbar with pain extending to the hips and legs, and Agaricus has a very marked LOCAL tenderness.

Pain and stiffness worse walking, better resting Weather makes no difference to her not to the pains. Most difficult patient to get any information out of. Cried when spoken to. Seems to be offended by our questions. Rigidity of mind.

Examination was just as difficult. All limbs rigid. Almost in spasm, like a Parkinsons Disease. Both upper limbs and lower/ Very much restricted movement of the hips particularly on abduction. Difficult to determine whether voluntary or not.

Most contradictory in her answers to questions Cannot get “at her.”

Unanimous choice of the clinic was Ignatia, chiefly on the contradictory replied to symptoms and to rigidity of limbs, the choice being confirmed by “taking offence easily”.

Kent, p. 69, does not give Ign., but Hering considers it most marked, and Nux has the symptom in the highest. Nux and Ignatia are very alike in many ways, perhaps due to the strychnine content of both. As Wheeler says, “Ignatia is PERVERSE”, and that just described this patient; but the perverseness, unlike Nux, shows itself not in an angry, violent manner but in an emotional way, as in this case.

An X-ray was ordered to determine the nature of the joint condition. This showed rather surprisingly, “Advanced osteo- arthritis of both hips. Articular cartilage nearly destroyed in both with sclerosis and flattening of bony surfaces.”

The patient returned a different person. She was better in herself she said, and her pains also.

The rigidity had almost gone from the limbs, though, of course, there was still a marked defect in movements.

But she was co-operative, smiling and happy.

This case should be considered alongside case 2. Where Nux vom. had a similar “loosening” effect. If this is maintained, life can be much easier for the patient and, though one can scarcely expect reorganization of destroyed cartilage, this has occurred (Dr. Boyd quoted such a case years ago). The destruction in the case resembles that present in Charcot joints and in the joints of syringomyelia, in both of which the cause is neurogenetic and not toxic.

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